Provider Demographics
NPI:1275194326
Name:ACROSS THE LIFESPAN, LLC
Entity Type:Organization
Organization Name:ACROSS THE LIFESPAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-418-0484
Mailing Address - Street 1:PO BOX 170
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AR
Mailing Address - Zip Code:72949-0170
Mailing Address - Country:US
Mailing Address - Phone:866-243-7203
Mailing Address - Fax:833-243-7203
Practice Address - Street 1:123 EGG HARBOR RD STE 703
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9410
Practice Address - Country:US
Practice Address - Phone:866-243-7203
Practice Address - Fax:833-243-7203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty